Venous leg ulcer (VLU) is a common disease in the field of vascular surgery, and is still a challenge in clinical practice due to its often delayed healing and frequent recurrence after healing. The current therapeutic options for VLU mainly include conservative treatment and surgical intervention. Here, the authors address the progress with regard to its drug therapy, compression therapy, traditional surgery, and endovascular and endoscopic treatment as well as managements for the perforator veins and wound surface, so as to provide reference for the surgery-based comprehensive treatment of VLU in clinical practice.